Inspection on 18/04/07 for Homefield House Care Home

This inspection was carried out on 18th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Homefield House Care Home 24/04/09

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Homefield House Care Home 11 Welholme Road Grimsby North East Lincs. DN32 0DT Lead Inspector Theresa Bryson Unannounced Inspection 18th April 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000067516.V336409.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000067516.V336409.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homefield House Care Home Address 11 Welholme Road Grimsby North East Lincs. DN32 0DT Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01472 341909 Ramesh Dalton Murugupillai Rabindranath Rommel Selliah Mrs Carol Ann Kirwin Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places DS0000067516.V336409.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: Homefiled House Care Home is a large old house situated in the centre of Grimsby in a residential area and overlooking a large public park. And with in easy reach of all types of amenities and the seaside town of Cleethorpes. The home can accommodate 24 people with problems of old age and dementia. The surroundings are an older house with a modern extension set in mature gardens with some care parking space. Most rooms have en-suite facilities and there are ample other toilets and bathroom and shower rooms. The home also has large sitting and dining areas and has a quiet room for service users to use. Equipment has been supplied to ensure that all acute and chronic needs of service users can be met and staff have the necessary equipment, which is regularly maintained. The Company is happy to accept service users who are privately funded as well as those funded through the local authority. The fees range from £360 to £450. Information about the services provided by the home are contained in the service users guide and statement of purpose, which is on display in the main reception area and is sent to all parties interested in using the home. DS0000067516.V336409.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day in April 2007. Prior to the inspection the event history since the last inspection was tracked and also survey forms sent to 10 relatives, (of which 4 were returned) and 9 to staff, (of which 4 were returned). During the course of the site visit 1 health professional was spoken to and 3 prior to the visit, 4 relatives and 6 people who use the service were interviewed. Also 7 staff were spoken to on the day. The manager was present throughout the site visit. What the service does well: The home has been very well maintained and has a very high standard of decoration and furniture. Care has been taken to ensure the furniture is in keeping with the style of the home, but people living there can bring in their own personal possessions, which they stated has helped them settle in. Prior to the visit each person is assessed to document their specific needs and this used to help staff prepare for the admission. Then the care plans are put in place and rigorously kept up to date to ensure everyone’s needs are being met at all times. There is also evidence that the people themselves and their loved ones have as much input as they want into this process. Documentation given to each person prior to admission details what the home can provide so they can make informed choice about the home and whether it will meet their needs. Many positive comments were received about the food in the home, which is prepared in a very clean environment. Meals can be taken in individual rooms, but there is also a dining room maintained to a very high standard and set out in a restaurant style. Recruitment practises in the home are very robust and ensure that staff are safe to work with the people who live there prior to employment. Then there is a through induction and training programme plus supervision, which ensures that they are fit to do their jobs. DS0000067516.V336409.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000067516.V336409.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000067516.V336409.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use this service experience excellent outcomes in this area. Prospective service users are given easy to read information about the home to ensure they are aware of the full range of services provided and are assessed in an holistic manner. EVIDENCE: During the course of this visit Standards 1,2,3 and 6 were checked. Since the new owners took over they have reviewed the Statement of Purpose and Service Users Guide which now has all the correct information contained within them, to enable prospective service users to make informed choice about the services the home provides. Prior to admission to the home the manager, care manager or senior carer will use an assessment tool which looks at the person in an holistic manner and DS0000067516.V336409.R01.S.doc Version 5.2 Page 9 enables staff to prepare for that admission to enable the person to feel welcomed and at ease when first arriving. Written evidence seen shows that this is carried out as soon as possible and that where the person is funded by the local authority the manager stated that they send their assessment details very quickly. The home does not provide intermediate care and therefore Standard 6 is not applicable. DS0000067516.V336409.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this area. People who use this service experience excellent quality outcomes in this area. Care plan documentation is kept up to date and accurate records kept to ensure that the delivery of care to individuals has been recorded. EVIDENCE: During the course of the visit Standards 7,8,9 and 10 were checked. Prior to the site visit survey forms were sent to 10 relatives and 4 were returned. During the site visit 4 relatives were spoken to, a visiting member of the Primary Care Trust and 6 services users. Each person stated very positive comments about the home. Such as “staff are very friendly and helpful” and “new owners are very nice and speak to use” and “night staff are marvellous”. Every one spoken to on the day appeared to be very relaxed and felt all their needs are being addressed and stated having their own belongs around them had made them feel very welcomed in the home. DS0000067516.V336409.R01.S.doc Version 5.2 Page 11 3 care plan records were tracked in depth and found to be of an excellent standard. All sections had been completed and evaluated appropriately to each person’s needs. There was also recorded evidence of when the management team audit each care plan. Staff felt they had ownership of each document and prided themselves on keeping them in a legible and tidy order. Events such as falls and other accidents were tracked by the inspector and found to have been accurately recorded. This ensures that all current needs are being met and monitored on a regular basis. A senior carer went over the drug administration records, which appeared to be accurate and safe practises, were in operation. The home feels supported by the local pharmacy and a health care professional interviewed at the time of the site visit stated that staff will ask for advice if the need arises. Staff were observed through out the day assisting service users with such tasks as lunch, personal care needs, bingo and preparing for a new admission. All were completed in a relaxed manner and afforded each person a lot of personal dignity and respect. Service users spoken to stated, “ staff are so good” and “ they really look after me”. Staff stated they feel there are sufficient numbers on duty to attend always to the needs of service users and that moral is good and every one works as a team. DS0000067516.V336409.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service experience good quality outcomes in this area. Service users are given choices to ensure their social needs are being addressed and they receive a nutritionally balanced diet prepared in a clean environment. EVIDENCE: During the course of the visit Standards 12,13,14 and 15 were checked. Service users and relatives spoken to stated there was always a variety of activities on offer for them to take part in, but only when they wanted to. Written evidence showed when each person had taken part in something, at what level of participation and how they enjoyed the event. This is coupled with the social needs assessment in the care plan, which the key workers keep up to date. Service users liked the personal shopping trips, which staff took them on as well as the variety of entertainers in the home and theatre visits which take place. The documentation showed that service users expectations were being DS0000067516.V336409.R01.S.doc Version 5.2 Page 13 met to suit their individual needs and the staff promoted independence within the framework of each individual’s needs and problems. The kitchen area was visited which was very clean and tidy. The last environmental health officer’s report in August 2006 only identified minor concerns, which have since been addressed. The home has a waitress service for meals, which service users appeared to appreciate. The dining area was very clean and the décor exceptionally well maintained, with care being taken by staff to lay the tables in a restaurant style and ensuring the atmosphere was relaxed and welcoming. Since the last inspection the new owners had purchased a new microwave, dishwasher, water boiler and various pieces of good quality china. The staff stated they had appreciated this and it has helped them to maintain an efficiently run kitchen. Generally service users liked the meals and made such comments as “ it is beautifully presented” and “on the whole is good” and “give me more than I can eat”. Some specific concerns regarding choices at some meal times were passed on to the manager, but the service users who choice to speak to the inspector about this aspect of the catering the inspector had already seen comments and concerns which had been dealt with either by the kitchen or management team recorded in the kitchen area comments book. DS0000067516.V336409.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use this service experience excellent quality outcomes in this area. Complaints are dealt with in a proactive way and staff trained to ensure they are aware if service users are suffering from abuse. EVIDENCE: During the course of the visit Standards 16 and 18 were checked. No complaints had been received since the last inspection, when the service history was checked prior to the visit. The complaints log was seen on the day and the one complaint received had been dealt with promptly with a satisfactory outcome recorded for all parties. Service users and relatives spoken to stated they had every confidence in the management team that any concerns would be addressed promptly. The training records of staff were checked and showed that most had received update training in the safeguarding of adults and all spoken to appear to be aware of issues, which would prompt them to pass on information. All polices had been reviewed to cover current legislation. This ensures that safe practises are in place and also sound recruitment and training policies to protect service users from abuse. DS0000067516.V336409.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use this service experience excellent quality outcomes in this area. The home was clean and tidy and maintained to a very high standard ensuring it was a safe place to live and work. EVIDENCE: During the course of the visit Standards 19 and 26 were checked. The manager accompanied the inspector on a tour of the building where all communal areas, all toilets and bathrooms and a selection of rooms were seen. The home has been maintained to a very high standard and been sympathetic to the design of the building. The standard of cleanliness in the home was also very high, which was appreciated by all the service users. DS0000067516.V336409.R01.S.doc Version 5.2 Page 16 They also stated it had been very comforting to them to bring in some personal belongings to personalize their rooms and helped them to settle in. Staff were awaiting a new admission during the course of the day and the room seen by the inspector. This was very clean and welcoming with flowers in the room and towels tastefully arranged. The new owners need to be aware that to maintain such a high standard requires constant up keep and a maintenance and renewal plan would supplement the monthly checks made by staff and day to day repairs made by the handyman. DS0000067516.V336409.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service experience good quality outcomes in this area. Robust recruitment practises are in place to ensure staff are safe to work with service users and trained to do their jobs. EVIDENCE: During the course of the visit Standards 27,28,29 and 30 were checked. The rotas of all staff were seen and there appeared to be adequate staff on duty to ensure that all the needs of service users were being met. This was reinforced by comments from service users such as “the staff are always there fro us day and night” and “nothing is too much trouble, all my needs are being met”. Relatives also stated that all staff were approachable and they had never had any problems finding staff to sit and talk with them. The Company has a robust recruitment policy, which is strictly adhered to, to ensure that staff are safe to work with service users prior to employment and after employment is commenced that a training programme is in place to enable them to do their jobs. 5 staff personal records were checked including the last person recruited and all documentation was in place and safety checks completed. DS0000067516.V336409.R01.S.doc Version 5.2 Page 18 The home has been very keen to encourage staff to attend training courses and the staff spoken to had appreciated this and stated it has enhanced the care they deliver to service users. There was documented evidence and certificates seen to show this has included topics such as NVQ in care training, dementia, care planning, safe handling of medicines and health and safety. As well as more service specific topics such as diabetes and continence care. This has ensured that staff have the skills to deal with problems of individual service users using the latest knowledge base and following current legislation and safe practices. 7 staff were spoken to during the course of the site visit and all made positive comments about working in the home and stated they felt very supported by the management team. DS0000067516.V336409.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use this service experience excellent quality outcomes in this area. The home has been well maintained to ensure that it is safe to live and work in and regular checks and consultation with service users, visitors and staff are recorded and acted upon where necessary. EVIDENCE: During the course of the visit Standards 31,33,35,36 and 38 were checked. The local management team have maintained their auditing checks to ensure that the home is a safe environment to live and work in. DS0000067516.V336409.R01.S.doc Version 5.2 Page 20 Documented evidence was seen that all maintenance checks have been carried out and the contracts in place to maintain equipment in use. Although water temperature checks are completed on a monthly basis this could encompass more outlets as this is predominately an older building and would benefit by more frequent checking of the water system and hence not put service users at risk from using too cool or too hot water. A quality assurance system is in place and is currently being expanded upon to ensure more stringent auditing takes place. Some staff are going to attend a new course soon, which will enhance their knowledge base and ensure they are up to date with current legislation. Documented evidence was seen on all the safety checks currently in place, and attention to detail was evident. The checks also encompass those of staff. Again documented evidence was seen and on speaking to staff they felt they benefited from the supervision sessions. Although well recorded the manager is looking at ways to improve the system currently in use. The current quality assurance system also takes into consideration the views of service users, visitors and staff, ensuring that they all feel they have a part to play in the running of the home, which on speaking to a selection of people appeared to be happening. The atmosphere in the home was welcoming and friendly and service users seen and spoken too appeared happy it was their home and staff moral was very high and visitors stated how welcome they feel and health professionals encouraged that staff use their expertise when required. DS0000067516.V336409.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 4 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 4 3 X 4 DS0000067516.V336409.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP26 Good Practice Recommendations It would be good practise for the home to monitor more water outlets on a regular basis to the safety of service users. 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